Get Cafeteria Reimbursement Request For Child Care ... - Bern & Pugh

Navigating the Cafeteria Reimbursement Request for Child Care from Bern & Pugh can be a straightforward process when you know how to fill it out accurately. This guide provides a step-by-step approach to assist you in completing the form online effectively.

Follow the steps to successfully complete your reimbursement request.

1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
2. Enter your personal details in the 'Name of Employee' field and provide your Employee ID number or Social Security number in the designated space.
3. Fill in your employee address accurately in the space provided to ensure proper communication regarding your request.
4. Indicate whether this is a change of address by selecting the appropriate option.
5. In the section labeled 'I hereby submit the following to be paid from my cafeteria plan,' specify the dependent care expense by providing the name of the dependent and the name of the babysitter or nursery.
6. Complete the dates of service in the designated field, ensuring that all relevant dates are included.
7. Clearly state the dollar amount you are requesting to be paid from the cafeteria fund, ensuring that the amount is specified.
8. Gather and attach documentation of incurred child care expenses, making sure it reflects dates of service, the name of the child care provider, and the amount paid.
9. Certify that the bills you submitted are eligible under your cafeteria plan by reviewing and signing in the 'Signature of Employee' field.
10. Record the date of your signature and provide your home phone and work phone numbers as required.
11. Once all fields are filled out, you can save your changes, download, print, or share the completed form as needed.

Complete your Cafeteria Reimbursement Request online now to ensure timely reimbursement!